Background and Aims: : Chronic obstructive pulmonary disease (COPD) is highly prevalent in the Nepalese population. It is associated with significant extrapulmonary effects among which cardiovascular complications are most common . Echocardiography evaluation mainly focused on effects on the right heart function is a salient tool to evaluate the presence of degree of pulmonary hypertension and also identify those group of patients who need more early aggressive therapy for the underling lung disease . We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart . Methods: An observational , cross sectional study was done on 50 patients with COPD who were admitted at Bir Hospital and underwent echocardiographic evaluation from Dec 2015 -Dec 2016 . All echocardiogaphic parameters focused on right heart and its function were assessed . Results: Out of total 50 COPD patients studied , majority of them were female (32 patients ,64%). The mean age group of the studied patients was 60.9 ±11.4 years . Pulmonary hypertension defined as sPAP>30 mmHg was evident in all of the patients ; with 30 patients (60% ), 14 (28 %) and 6(12 %) patients having severe, moderate and mild pulmonary hypertension respectively . RV dysfunction was evident with reduced average TAPSE values (1.59± 0.38 cm) and elevated RIMP values (0.58±0.16). Conclusion: Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness .
Congenital anomalies of the coronary arteries are a cause of sudden cardiac death. Of the known anatomic variants, anomalous origination of a coronary artery from an opposite sinus of Valsalva (ACAOS) remains a major clinical issue and a challenging condition to treat. Congenital coronary anomalies are likely to be under-recognized, as completing an anatomic assessment in a very large portion of the population would seem unfeasible. However, we present a case report with image of a 49 year old male presented with acute non-ST elevation ACS for which he underwent diagnostic angiography of the coronary system which revealed a common origin of both right and left main coronary artery from right sinus of Valsalva with significant obstructive lesion in the mid segment of right coronary artery. However, due to financial constraints CT angiography could not be done in this patient to identify the detail anatomy and the course of the anomalous left coronary artery origin (L-ACAOS). He was managed medically with dual antiplatelets, beta blockers, nitrates and ACE inhibitors.
A 29 year old female patient presented to the cardiology OPD with history of progressive breathlessness of NYHA class II and palpitation of 1 year duration. Under evaluation, she underwent 2D transthoracic echocardiography that revealed an extra septum that subdivided the left atrium into proximal and distal chambers. The diagnosis of cor triatriatum was hence made and was referred to surgical team for corrective surgery. The communication between proximal and distal chamber was provided by large fenestration in the fibromuscular membrane.Nepalese Heart Journal 2017; 14(1): 33-34
Background and Aims: Prosthetic valve thrombosis remains a major complication of valve replacement surgeries in Nepal. A number of patients present with thrombotic complications mainly due to poor anticoagulation status with irregular INR checkup at the remote areas of Nepal. Thrombolysis is the preferred method in the management of stuck valve patients due to financial issues . We aimed to retrospectively study the clinical profile and management trends of stuck prosthetic valveMethods: A one year retrospective data of 23 patients (Jan 2015 - Jan 2016) admitted with diagnosis of prosthetic valve thrombosis were studied. The demographic profile, clinical parameters and in hospital outcome were analysed.Results: Out of 23 patients, majority were female (52.2%) with the age group 13-49 years (mean = 35). Sixteen patients (69.6%) presented with INR value < 1.5 at admission. Twenty patients ( 86.9%) were thrombolysed with streptokinase while 3 patients ( 13.1 %) were subjected to treatment with tenecteplase . Valve thrombosis was most common at the mitral position 17 (73.9%) patients. In hospital mortality was seen in 5 ( 21.7%) patients and there were no major bleeding events or new stroke noted.Conclusion: Majority of patients with prosthetic valve thrombosis presented with a subtherapeutic INR value. Thrombolysis can be a useful option in the management of prosthetic valve thrombosis patients in a less resourceful country.Nepalese Heart Journal 2017; 14(1): 9-11
Background and Aims: Prosthetic valve thrombosis is a life- threatening complication of post-valve replacement surgeries. A number of patients present with thrombotic complications mainly due to poor anticoagulation status with irregular INR checkup especially from remote areas of Nepal. Our aim was to study the clinical profile and management of prosthetic valve thrombosis in our center. Methods: A prospective observational study of 45 patients (July 2017 – Jun 2019) admitted at Shahid Gangalal National Heart Centre, with the diagnosis of prosthetic valve thrombosis were studied. The demographic profile, clinical parameters and in hospital and 1 year outcome were analyzed. Results: Out of 45 patients, majority were female (60%) with the age 11-67 years with mean age of 34.9 ± 6.7. Twenty nine patients (64.4%) presented with sub-therapeutic INR value at admission. 46.7% patient had atrial fibrillation at the time of presentation. 88% patients presented within one week of onset of symptoms with shortness of breath being primary complaint, present in 95.6% of the patients. Forty two (86.9%) were thrombolysed with streptokinase while 3 patients underwent surgery. Valve thrombosis was most common at the mitral position 39(87%) patients. In hospital mortality was 13.3% and there were no major bleeding events or new stroke noted. Conclusion: Majority of patients with prosthetic valve thrombosis presented with a sub-therapeutic INR value and poor patients' compliance. Thrombolysis is a useful option in the management of prosthetic valve thrombosis patients especially in countries like Nepal.
Ellis Van Creveld syndrome (EVC) is a rare genetic disorder having autosomal recessive inheritance characterized by chondrodystrophy, polydactyly, ectodermal dysplasia, and various cardiac anomalies. Acromelic shortening of upper and lower limbs, genu valgum, deformed teeth, short ribs and narrow thorax and other systemic anomalies complete the picture of this syndrome. The patients with the syndrome rarely survive into adulthood. Here, we report a 30 year old male with EVC presenting for the first time in middle age with Common atrium anomaly.
Background: There is limited data on feasibility and safety of coronary interventions performed using radial artery at anatomical snuffbox as vascular access point in South Asian region. Our study attempts to evaluate the feasibility and safety of coronary angiography and percutaneous coronary intervention using transradial access at anatomical snuffbox.Methods: Transradial access at anatomical snuffbox was attempted in 128 consecutive patients, who were planned for coronary angiography and/or percutaneous coronary intervention. Success in vascular access, completion of planned procedure and complications encountered, including patency of radial artery after the procedure, were investigated. Results: A total of 128 patients (76 males [59.4%]; 52 females [40.6%]) between 44-78 years of age (mean age, 59.0 +/- 10.2 years) were included in the study. Distal radial artery puncture and sheath placement was successful in all patients however planned procedure was completed in 126 (98.4%) patients. Total 90 coronary angiographies and 36 percutaneous coronary interventions were performed of which five were primary percutaneous coronary intervention. We encountered brachial artery spasm among two patient (1.5%) and significant pain and swelling among three patients (2.3%). No bleeding complication, numbness or parasthesia were observed on follow-up. Patients had average pain rating of 2.4+/- 1.1 in visual analogue pain rating scale. There were no instances of radial artery occlusion after the procedure.Conclusions: Distal radial artery, at anatomical snuffbox, is a safe and feasible alternative vascular access site for coronary angiography and percutaneous coronary intervention. Keywords: Cardiac catheter; coronary angiography; feasibility studies; percutaneous coronary intervention; radial artery; vascular access device
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.